Treatment of Knee Arthritis (Part III) Total Knee Home Discharge Instructions TABLE OF CONTENTS

Transcription

1 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins TABLE OF CONTENTS Table f Cntents: Page 1 Hw t Get Better the Fastest : D yur exercise prgram 4 times a day. Page 2 Nrmal Things t Expect: Yu had surgery. Dn t wrry abut them! Realistic Expectatins: Yu will nt be All Better in 8 weeks! General Warnings: Things t watch ut fr. General Wund Care: Fr mre see Wund Care Instructins. Page 3 Edema/Leg Swelling Cntrl: Hw t decrease swelling in yur feet and legs. Nrmal Swelling & Bad Swelling : Is it a clt r nt? Cnstipatin Preventin: Narctics & nt enugh water bind yu up! Shwers, Baths Ht Tubs and Pls: Pain Cntrl Prgram: Page 4 Fllw the medicatin instructins frm Dr. Van Hrne s surgical scheduler r Dr. Van Hrne. Take Yur Primary (Nn-Narctic) Pain Medicatins fr 2 mnths. Narctic Pain Medicatins: Cme ff f them as sn as yu can. Anti-Nausea/Anti-Itch Medicatins: Take them 20 minutes befre narctics. Other New Medicatins: Page 5 Stmach Prtectrs: Prevent bleeding ulcers. Take fr 3 mnths. Bld Thinners: Prevent Bld Clts, Phlebitis, and Pulmnary Emblism. Physical Therapy & Fllw Up Appintments: Exercise Prgram & Physical Therapy: Start exercise prgram day f surgery! Page 5-7 Knee Flattening (Extensin) Prgram: 15 minutes 4 times a day. Knee Bending (Flexin) Prgram: 15 minutes 4 times a day. Knee Strengthening Prgram: 15 minutes 4 times a day. Walking Prgram: 15 minutes 4 times a day fr 2 weeks. SILAX (Standing, Independent, Lw impact, Aerbic exercise): 6 hurs a week starting 14 days after surgery. THE MOST IMPORTANT COMPONENT OF YOUR EXERCISE PROGRAM. Precautins: Listen t yur bdy. Page 7 Driving: Dn t drive until 6 weeks. Kneeling: It is OK. Skin Desensitizatin Prgram: Turn ff the little skin nerves. Wund Care Instructins: Page 7-8 General Infrmatin Wund Care & Dressings Expected Nrmal Drainage Abnrmal Bad Drainage Wund Care Supplies: What and where t get them. Page 8-9 Paragn Orthpedic Center fax Page 1 f 9

2 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins Read this at least 6 times befre the day f surgery. There is just t much imprtant infrmatin t knw and remember. Dn t expect t learn it the day f surgery, yu will be n Drugs & will have a difficult time remembering anything! Hw t Get Better the Fastest : If yu d nt fllw my exercise prgrams, dn t expect, by magic, yu will get better. I nly did the easy 5%. Yu still have t d the hard 95%. If yu want a rapid recvery and the best mtin, start yur knee exercise prgram the day f surgery and d it 4 hurs a day when yu g hme. See the Exercise sectin. Get yur knee flat 15 minutes 4 times a day. When yu get it flat, yu can stp. Get yur knee bending 15 minutes 4 times a day. When yu get 120 degrees by yurself, yu can stp. D yur knee strengthening exercises 15 minutes 4 times a day. Maximum f 5 exercises at a time. If yur physical therapist tries t give yu mre, tell them t take an exercise away. Cntinue fr 2 mnths, and then back ff t twice a day fr 2 mnths. Walk 15 minutes 4 times a day. At hme, in the yard r where ever wrks fr yu. At 2 weeks after surgery, resume yur Standing Lw Impact Aerbic Exercise prgram 6 hurs a week. Water Walking, Walking n Natural Surfaces, Elliptical Stryder etc. Cntinue fr next 4 mnths. Nrmal Things t Expect: Yu had surgery. Dn t wrry abut them! Drainage frm the incisin fr up t 6 days after surgery. See Wund Care Instructins. Knee bruising and redness fr abut 2 weeks. It will get wrse fr the first 3-5 days. It may g all the way dwn t yur heel. Bld flws in the fat layer and ges t the lwest pint. Knee swelling fr 2-4 mnths and warmth fr 4 t 6 mnths. Hey yu had a big guy with a chain saw in yur knee! Leg swelling and edema fr up t 6 mnths. See Edema/Leg Swelling Cntrl. Numbness alng the utside f yur incisin. Little skin nerves are cut with a knee incisin. Yu wn t ntice it in a few mnths. Skin Hypersensitivity t tuch arund yur incisin scar and discmfrt with kneeling. See Skin Desensitizatin Prgram. Realistic Expectatins: Yu will nt be All Better in 8 weeks! Yu will make rapid weekly prgress fr the first 8 weeks then it slws dwn. Yu are just healing at 8 weeks. Dn t be disappinted that yu are nt all better in 8 weeks. Yu knw the It s the Climate sign n 6 th Street? I ften wnder if I shuld nt put a sign at my frnt dr that sez It s Just 8 Weeks! It will be 4-6 mnths befre yu frget yu had a knee replacement. A Ttal Knee Replacement is nt like a fast fd restaurant where yu get yur fd quickly; it is mre like fine dining. General Warnings: Things t watch ut fr. If yu have chest pain r shrtness f breath (different frm yur usual), g t the Emergency Rm. Yu may be having a heart attack r a bld clt ging t yur lungs. If yu have increasing leg swelling that des nt g away with elevatin cmbined with new/different pain when yu squeeze yur calf, call Paragn Orthpedics. Yu may have a bld clt. If yu feel sleepy all the time r feel yur thinking is nt clear, call Paragn Orthpedics. Yur pain medicatins may need t be reduced. Call fr temperatures > r if yur knee becmes mre red ht and swllen 6 days after surgery. Call if yu have new greenish pus like drainage r drainage that cntinues mre than 6 days after surgery. Paragn Orthpedic Center fax Page 2 f 9

3 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins If yu cannt sleep, yur pain medicatin may be the prblem. With time, narctic pain medicatins can keep yu awake. Call Paragn Orthpedics. General Wund Care: Fr mre see Wund Care Instructins. Change Dressing every day and as needed. Cntact Paragn Orthpedics if yu have drainage beynd 6 days after discharge frm hspital. Cntact Paragn Orthpedics fr increasing drainage, pus-like drainage, r increasing redness and pain. Yu may shwer the day after surgery if drainage has stpped. Wash gently with antibacterial sap like Lever. Yu may resume water walking, pl exercise and ht tub furteen days after surgery if wund is clsed, staples are ut, drainage has stpped and yur Physical Therapist says it is OK. Edema/Leg Swelling Cntrl: Hw t decrease swelling in yur feet and legs. Leg Elevatin: This is what gets the extra fluid ut f yur legs. Elevate feet ABOVE yur heart 15 minutes, 4 times a day t reduce swelling in yur legs. The higher the better. Example: n cuch with feet prpped n a pillw n the cuch arm. Sitting in a recliner wn t get yur legs high enugh t get the edema dwn! Knee high cmpressin stckings: They help, but it is the elevatin that really des the jb. Wear them fr 14 days after surgery. Yu may take them ff fr shwering, skin care and washing f stckings. Nrmal Swelling & Bad Swelling : Is it a clt r nt? Nrmal Swelling (After Surgery): Yu can expect t have leg swelling fr 2-6 mnths. Nrmal Swelling/Edema ges dwn when yu sleep (first thing in the mrning yu dn t have much edema) r ges dwn when yu elevate yur legs. With Nrmal Swelling/Edema if yu squeeze yur calves, they are nt mre painful than usual (yu prbably dn t have a clt). Swelling f bth legs is prbably a sign f fluid retentin and is prbably Nrmal Swelling. If yu take a water pill r medicatins fr high bld pressure yur bdy may need sme help t get the extra fluid ff, elevate yur legs higher/mre ften and call yur PCP. Yu may need an adjustment f yur medicatins. Bad Swelling : Culd be a sign f a bld clt. If yu have either f the belw, Call Paragn Orthpedics! Yu may need an Ultrasund evaluatin f yur legs t make sure yu dn t have a clt. Bad Swelling/Edema desn t g dwn when yu sleep (yu wake up in the mrning and yu still have a lt f swelling/edema) and the swelling/edema desn t g dwn when yu elevate yur legs abve yur heart, When yu squeeze yur calf muscles, they hurt mre than nrmal r have a new pain. Cnstipatin Preventin: Narctics & nt enugh water bind yu up! See the HOW TO AVOID CONSTIPATION WHILE TAKING NARCOTIC PAIN MEDICATION handut frm Paragn Orthpedics. Dn t let yurself get cnstipated while n narctics. Have a bwel mvement at least every 2-3 days while n narctics. Shwers, Baths, Ht Tubs and Pls: Yu may shwer when drainage n a 12-hur-ld dressing is n mre than quarter sized. Generally the day after surgery. Let the water run n the wund. D nt scrub the wund. Blt it dry and apply new dressing Paragn Orthpedic Center fax Page 3 f 9

4 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins N bathtubs, ht tubs r pls fr 14 days after surgery. Pain Cntrl Prgram: Fllw the medicatin instructins given t yu by Dr. Van Hrne s surgical scheduler r Dr. Van Hrne. Take Yur Primary (Nn-Narctic) Pain Medicatins fr 2 mnths. When yu can sleep thrugh the night withut knee discmfrt waking yu up, yu can stp them. Otherwise take them fr anther mnth. By using them as directed, yu may nt need the Narctic Pain Medicatins fr mre than a few days t a week! They are Nn Addictive and Nn Cnstipating. They wrk especially well fr nighttime pain and types f pain that narctics dn t help. Examples: Acetaminphen (Tylenl) Yu take 2 (tw) 325 mg tabs r 1 (ne) 650 mg tab Breakfast, Lunch, Dinner & Bedtime. This is an ver the cunter medicatin. WARNING: D Nt take mre than 3000 mg a day. If yu are taking a cmbinatin medicine like Nrc r Vicdin, yu prbably shuld nt take any scheduled Acetaminphen until yu are ff f it. NSAIDs Yu take them nce r twice a day. They are aspirin like pain medicatins. They are fr pain, nt fr swelling. Examples: Melxicam (Mbic), Celebrex, Naprsyn (Aleve), Diclfenac (Vltaren) and Ibuprfen (Mtrin). Narctic Pain Medicatins: Cme ff the Narctic Pain Medicatins as sn as yu can (2 days-2 weeks after surgery). Many patients never fill their narctic prescriptin after surgery and dn t use them at all when they g hme. I recmmend yu stp all Narctic Pain Medicatins as sn as yu can. On the ther hand, use them if yu need them! These are the same medicatins yu used in the Hspital. Yu may take less than prescribed and stp as sn as yu want. IF yu are still taking these medicatins tw weeks after surgery and yu still feel like yu need them, stp taking them n a regular schedule. Take them nly as yu need. Narctics are a necessary evil fr many patients. Narctics are Addictive. Narctics cause cnstipatin (fllw ur directins n hw t keep yur bwels mving), difficulty sleeping (yur bdy gets used t them), pain at night (yur bdy starts wanting the Narctics), sedatin, hallucinatins, and cnfusin. Examples: Tramadl (Ultram), Oxycdne, Cdeine, Hydrmrphne (Dilaudid), Mrphine Sulfate, and Hydrcdne with acetaminphen (Nrc, Vicdin). Anti-Nausea/Anti-Itch Medicatins: These medicatins prevent nausea/itching caused by narctic pain medicines. Fr them t wrk well, take them abut 20 minutes befre yu take the narctic pain medicatin. Yu can stp them when yu cme ff the narctic pain medicatins. Examples: Zfran (ndansetrn), Phenergan (prmethazine), Atarax (hydrxyzine), Benadryl (diphenhydramine), & Zyrtec (cetirizine). Paragn Orthpedic Center fax Page 4 f 9

5 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins Other New Medicatins: Stmach Prtectrs: Take these t prevent bleeding ulcers caused by the stress f surgery and medicatins (NSAIDs). Take them as lng as yu take NSAIDs. If yu already take ne nrmally fr acid stmach, reflux, GERD, r ulcers, yu will take yur regular ne unless it cnflicts with ne f yur ther medicatins. Examples are Omeprazle (Prilsec) and Famtidine (Pepcid). Bld Thinners: Helps t Prevent Bld Clts, Phlebitis, and Pulmnary Emblism. Aspirin 325 mg is the mst cmmn bld thinner fr patients withut a histry f clts. If yu take a bld thinner regularly, resume it when yu g hme. If yu take Warfarin, we resume yur regular dse while yu are in the hspital and cntinue it after discharge. Have yur PT/INR checked twice weekly fr tw weeks at yur regular Warfarin clinic r prvider. If yu are n Plavix, Pradaxa r Xarelt, yu resume taking them the mrning f the third day after yu g hme. Fllw Up Appintments: My ffice sent rders t yur physical therapist fr 6 visits ver ne mnth. If they have nt cntacted yu, call them. Yu shuld start yur therapy the secnd r third day after yu g hme. Yu already have a fllw-up in Dr. Van Hrne s ffice with a Physician s Assistant r Nurse Practitiner at 4 weeks pst-p. We will get X-Rays and renew Physical Therapy if needed. Yu have a fllw-up with Dr. Van Hrne 8 weeks pst-p t check yur prgress. Exercise Prgram and Physical Therapy: Start yur exercise prgram the day f surgery! D yur exercise prgram 4 hurs/day. What else mre imprtant have yu gt t d? Yu dn t g t physical therapy t d yur exercises. Yu g t physical therapy fr them t bserve, crrect and advance yur exercise prgram. Yur physical therapist des nt make yu better, nly yu d! After yur first mnth f physical therapy, I can nly rder additinal physical therapy if yur therapist can validate they are Ding smething fr yu that yu cannt d n yur wn. I dn t want yu stuck with a huge bill yur insurance wn t pay fr! Knee Flattening (Extensin) Prgram: Schedule: 15 minutes 4 times a day. When yu get it flat and keep it flat, yu can stp. If yu d nt get yur knee fully flat in the first 7-10 days, yu will never get it flat and yu may always walk with a limp. Sitting in a reclining lunge chair is the #1 reasn fr nt getting yur knee int full extensin. Even in the very best reclining lunge chairs, when yu recline, yur knee bends (is flexed) and yu cannt get it fully flat (extended). If yu want t sit in yur reclining lunger, d nt recline. Place yur heel n anther chair and wrk n getting it flat. Seated in a chair, rest yur heel n anther chair leaving the back f yur knee unsupprted, Turn yur tes in until yur kneecap pints straight up at ceiling (tes internally rtated ), Sit there and let yur knee stretch at least 15 minutes fur times every day until yu get yur knee fully flat. Weight may be added abve yur knee if yu are nt getting yur knee flat and yu can tlerate the weight. In bed, put a pillw under yur heel s the back f yur knee desn t tuch the bed, Paragn Orthpedic Center fax Page 5 f 9

6 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins Rll yur hips in a little r turn yur tes in until yur kneecap pints straight up at ceiling (tes internally rtated ) Use this psitin as much as pssible when awake in bed until yu get yur knee fully flat. Knee Bending (Flexin) Prgram: Schedule: 15 minutes 4 times a day. Get & keep 120 degrees just hanging t gravity & yu can stp. Yu will have clse t 120 degrees f bend the day f surgery. Keep it! Yu will be stiff first thing in the mrning. Wrk yur knee right away t get the edema ut and keep yur 120 degrees. If yu d nt get and keep the Bend (Flexin) early, yu will develp scar preventing yu frm bending. Yur therapist will t try t Tear the scar fr yu! This is very painful and it desn t wrk. Just d it yurself. Lying n yur back, cradle yur thigh with yur hands and flex yur hip s yur kneecap is pinting at the ceiling. Let gravity bend yur knee as much as yu can tlerate (Dr. Van Hrne gt yu t 120 degrees in the OR with yur leg just hanging t gravity). Let it hang fr tw minutes then relax fr a minute and repeat. D a ttal f five (5) 2 minute stretches If yu cannt get yur hands arund yur thigh, use a twel fr extra length. Knee Strengthening Prgram: Schedule: 15 minutes 4 times a day fr the first 8 weeks, then twice a day fr anther 2 mnths. This is the exercise prgram that yur physical therapist taught yu befre surgery and the ne the therapist/nurse reinfrced the day f surgery. If yu dn t have a handut f yur exercises, call yur therapist and get ne! Yu shuld have a maximum f 5 exercises at a time (yu cannt d mre in 15 minutes). Each time yu master, r an exercise becmes t easy, yur therapist will add a new harder ne and take the easier ne away. Walking Prgram: Schedule: 15 minutes 4 times a day at hme, in the yard r where ever wrks fr yu. Yu d this fr the first tw weeks after surgery then yu g back t SILAX. Yu need t get yur walking muscles back SILAX (Standing, Independent, Lw impact, Aerbic exercise). THIS IS PROBABLY THE MOST IMPORTANT COMPONENT OF YOUR EXERCISE PROGRAM IF YOU WANT A RAPID AND FULL RECOVERY. Schedule: 6 hurs a week starting 14 days after surgery r the day after yu get yur staples ut, 2 weeks, and cntinue fr 6 mnths. Resume the Standing, Independent, Lw impact, Aerbic exercise(s) f yur chice. Water walking, walking n natural surfaces (grass, sand, unpacked dirt), elliptical strider/trainer machine, Nrdic track machine, r Stair Climber Machine. Wrk up t 6 hurs per week and cntinue this fr next 6 mnths. Dn t use Treadmills r walk n cncrete r asphalt as yur primary frm f exercise fr 3 mnths. They cause bursitis, jint pain and back pain. Dn t use a bicycle r swimming as yur primary frms f Standing, Independent, Lw Impact, Aerbic exercise prgram (as they are neither). They d nt simulate walking, nr encurage balance training. D yu want t ride the Tur de France, swim the English Channel r d yu want t walk? Paragn Orthpedic Center fax Page 6 f 9

7 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins Precautins: Listen t yur bdy, if yu hurt mre than an hur and a half (1 ½) after activity r exercise, yu are verding it. Driving: Dn t drive until 6 weeks. Yu are ff yur walker, ff the narctics & yu feel safe. Studies shw it des nt matter whether yu had surgery n yur right r left leg, n driving fr 6 weeks! If yu drive befre 6 weeks, I cannt defend yu in a curt f law. I suggest that yu try driving in a parking lt befre yu actually g ut n the rad. Kneeling: It is OK. Just dn t kneel n brken glass, ld fish hks, r ther sharp pinty things. There is n mechanical reasn fr yu nt kneel. Yur knee is metal and plastic. T let yur incisin heal, I suggest yu dn t kneel fr abut 4 weeks. Put a pad dwn t kneel n. If yur incisin/skin is t sensitive, start the Skin Desensitizatin Prgram. Mst patient s majr prblem with kneeling is nt their knee replacement but that they cannt get back up. Their cre muscles are t weak. Discuss it with yur therapist. Skin Desensitizatin Prgram: Turn ff the little skin nerves. If yur incisin/the frnt f yur knee is very sensitive r uncmfrtable t tuch, the little skin nerves are irritated and hyperactive frm surgical trauma. Yu need t reeducate them & turn them ff! Starting abut 2 weeks after surgery Twice a day squeeze ½ a capsule f vitamin E il n the incisin and massage the incisin with yur fingers fr several minutes. Use side-t-side, up-and-dwn, and circular mtins. Rub the sensitive area 4 times a day just until it feels ht. Then stp. Start with a piece f silky fabric. When it is n lnger sensitive with the silky fabric, mre up t rugher and rugher fabrics until yu can tlerate new denim. Wund Care Instructins: Dressings, Expected Drainage and Abnrmal Drainage Knee. General Infrmatin 1. Yur wund was clsed superficially with Dermabnd/Prine (skin glue & elastic mesh tape) r staples. a. If the Dermabnd/Prine has nt fallen ff after 14 days, yu may peel it ff. b. If yu have staples, yur physical therapist shuld remve them arund 14 days after surgery. 2. Expect t have sme drainage frm yur wund fr up t 6 days after surgery. 3. Yu may shwer when drainage n a 12-hur-ld dressing is n mre than quarter sized. Generally the day after surgery. Let the water run n the wund. D nt scrub the wund. N bathtubs, ht tubs r pls fr 14 days after surgery. 4. D nt put antibitic intments r creams n wund. 5. Expect nrmal bruising and redness t prgress fr 3-5 days after surgery. 6. If yu have drainage, yu may paint the wund with Idine (Betadyne) twice a day r with each dressing change. Painting, means putting Betadyne n a 4x4 and bltting it n the wund area. Betadyne helps dry ut wund drainage and reduce the risk f infectin. 7. Island Dressings 4 x 10 (big band aides) are cnvenient and easy t use. 8. If yu d nt have wund dressing materials already, see my LIST f SUGGESTED PATIENT WOUND SUPPLIES fr KNEES. Paragn Orthpedic Center fax Page 7 f 9

8 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins Wund Care & Dressings 1. Mst patients will nly have nly mild drainage frm their wund and island dressings 4 x 10 are adequate. a. Change daily and as needed up t several times a day. 2. D nt pull ff the Dermabnd/Prine when ding dressing change. If 4x4s are sticking t it yu can wet them with warm water r Betadyne, then peel them ff while hlding dwn the Dermabnd/Prine. a. If the Dermabnd/Prine has nt fallen ff by 14 days after surgery, yu may peel it ff. 3. If yu have staples, yur physical therapist will remve the staples 14 days after surgery. 4. D nt put antibitic intments r creams n wund. Expected Nrmal Drainage 1. Drainage that is bldy, r yellw bldy is nrmal and expected fr up t 6 days after surgery. 2. Drainage shuld decrease each day. 3. Sudden large gush f bldy r yellw bldy drainage at 3-5 days after surgery is nt uncmmn. Old bld is finding its way ut. Dress with large Bulky dressing as belw. As lng as drainage slws dwn and stps in a day r s there is nthing t wrry abut. If drainage des nt decrease and cntinues, yu need t cntact Dr. Van Hrne s ffice n the next business day. 4. If yu bleed enugh t sak thrugh yur dressing the first tw days after surgery, dn t panic and dn t g t the emergency rm (Yu will wait hurs. They will lk at it, tell yu t change yur dressing as needed, and that nthing is wrng. They will charge yu an exrbitant fee that yur insurance may nt pay!). a. If the bld wants t cme ut, we want it t cme ut! Yu just had surgery. b. Dr. Van Hrne prmises yu that yu are nt bleeding t death. There is a pcket f ld bld just under the skin. It is nt active bleeding. c. Just wrap it in a twel (s it desn t mess up the bed) and place a several pund bag f ppcrn seeds r rice fr pressure n the incisin fr several hurs (helps the wund seal up and stp draining sner). d. Change yur dressing arund 10 r 11 the next mrning. If yu are still having mre drainage than an Island Dressing will sak up in 12 hurs i. Place a new large Bulky dressing n the wund (just like the ne yu had and yur discharge nurse taught yu t d). 1. Fld each sterile gauze pad in half and stack n the incisin ( x4s) 2. Place 2 ABDs ver 4x4s 3. Wrap snuggly with 4-inch Ace elastic wrap e. Again, place a several pund bag f ppcrn seeds r rice fr pressure n the incisin when yu are nt ding yur walking r strengthening exercises. f. Change dressing daily and as needed. g. If yu cntinue t have drainage that saks thrugh the Bulky dressing fr mre than 2 days after surgery, call Dr. Van Hrne s ffice the next business day fr a wund check. h. Start dressing changes with island dressings as sn as drainage slws dwn enugh t handle it. i. If yu did nt purchase ne f Dr. Van Hrne s Knee Dressing Care Packages frm Grants Pass Pharmacy g t a pharmacy (call the pharmacy first t make sure they have what yu need) and purchase what yu need fr dressing changes. Abnrmal Bad Drainage 1. Drainage that cntinues mre than six (6) days after surgery needs t be reprted t Dr. Van Hrne s ffice n the next business day. 2. Green r ful smelling drainage needs t be reprted t Dr. Van Hrne s ffice n the next business day r cntact the physician n call if it is the weekend. WOUND CARE SUPPLIES Mst pharmacies and medical supply shps d nt carry the wund care supplies yu will need when yu g hme. The easiest way t get yur hme wund care supplies is t purchase Dr. Van Hrne s Knee Dressing Care Package frm Grants Pass Pharmacy 414 SW 6 th St. Grants Pass, Oregn. PH# ( ). Hurs f peratin: 9am-7pm M-F & 9am-6pm Sat. They make these up just fr my patients. It is designed t be ne-stp Paragn Orthpedic Center fax Page 8 f 9

9 Treatment f Knee Arthritis (Part III) Ttal Knee Hme Discharge Instructins shpping and meet yur needs fr just abut every situatin. It cntains mre supplies than the average patient will need/use. If yu want t d it n yur wn and just get what yu need when yu need it, yu will save a few bucks, but yu will have t search arund fr extra supplies if yu need them. Call the pharmacy befre yu g r yu may be frustrated (furteen) Island Dressings 4 x 10 r 3.5 x 10 (big band aides) a. Brand Names include Kendall, McKessn and 3M Medipre bxes f sterile gauze 4x4s ( per bx - need per dressing change). a. Many brand names including Jhnsn & Jhnsn, Kendall, and McKessn (tw) ABD 5 x9 (r bigger) Dressings a. Brand names Kendall, Medline and thers 4. 2 (tw) 4-inch Ace elastic wraps 5. 1 (ne) Pvidne-Idine Slutin 10% (Betadyne Slutin) 4 unce bttle Paragn Orthpedic Center fax Page 9 f 9